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Public health implications of wireless technologies

Cindy Sage

∗

, David O. Carpenter

Sage Associates, 1396 Danielson Road, Santa Barbara, CA 93108, USA

Institute for Health and the Environment, University at Albany, Rensselaer, NY, USA

Received 18 January 2008; accepted 30 January 2009

Abstract

Global exposures to emerging wireless technologies from applications including mobile phones, cordless phones, DECT phones, WI-FI,WLAN, WiMAX, wireless internet, baby monitors, and others may present serious public health consequences. Evidence supporting a publichealth risk is documented in the BioInitiative Report. New, biologically based public exposure standards for chronic exposure to low-intensityexposures are warranted. Existing safety standards are obsolete because they are based solely on thermal effects from acute exposures. Therapidlyexpandingdevelopmentofnewwirelesstechnologiesandthelonglatencyforthedevelopmentofsuchseriousdiseasesasbraincancersmeans that failure to take immediate action to reduce risks may result in an epidemic of potentially fatal diseases in the future. Regardless of whetherornottheassociationsarecausal,thestrengthsoftheassociationsaresufﬁcientlystrongthatintheopinionoftheauthors,takingactionto reduce exposures is imperative, especially for the fetus and children. Such action is fully compatible with the precautionary principle, asenunciated by the Rio Declaration, the European Constitution Principle on Health (Section 3.1) and the European Union Treaties Article 174.© 2009 Elsevier Ireland Ltd. All rights reserved.

Keywords:

Wireless technology; Brain cancer; Radiofrequency; Cell phones; Wireless antenna facilities; Childrens’ health

1. Introduction and background

Exposuretoelectromagneticfields(EMF)hasbeenlinkedto a variety of adverse health outcomes that may have sig-nificantpublichealthconsequences[1–13].Themostserious healthendpointsthathavebeenreportedtobeassociatedwithextremelylowfrequency(ELF)and/orRFincludechildhoodand adult leukemia, childhood and adult brain tumors, andincreasedriskoftheneurodegenerativediseases,Alzheimer’sand amyotrophic lateral sclerosis (ALS). In addition, thereare reports of increased risk of breast cancer in both menand women, genotoxic effects (DNA damage and micronu-cleation), pathological leakage of the blood–brain barrier,altered immune function including increased allergic andinflammatory responses, miscarriage and some cardiovascu-lar effects[1–13].Insomnia (sleep disruption) is reported in studies of people living in very low-intensity RF environ-ments with WI-FI and cell tower-level exposures[85–93].Short-termeffectsoncognition,memoryandlearning,behav-ior, reaction time, attention and concentration, and altered

∗

Corresponding author. Tel.: +1 805 969 0557; fax: +1 805 969 5003.

E-mail address:

sage@silcom.com(C. Sage).

brainwave activity (altered EEG) are also reported in the sci-entiﬁcliterature[94–107].Biophysicalmechanismsthatmay account for such effects can be found in various articles andreviews[136–144].The public health implications of emerging wireless tech-nologies are enormous because there has been a very rapidglobal deployment of both old and new forms in the last 15years.IntheUnitedStates,thedeploymentofwirelessinfras-tructure has accelerated greatly in the last few years with220,500 cell sites in 2008[14–16].Eighty-four percent of the population of the US own cell phones[16].Annualized wireless revenues in 2008 will reach $144 billion and USspending on wireless communications will reach $212 bil-lion by 2008. Based on the current 15% annual growth rateenjoyed by the wireless industry, in the next 5 years wirelesswill become a larger sector of the US economy than both theagriculture and automobile sectors. The annualized use of cell phones in the US is estimated to be 2.23 trillion minutesin2008[16].Thereare2.2billionusersofcellphonesworld- wide in 2008[17]and many million more users of cordless phones.Over 75 billion text messages were sent in the UnitedStates, compared with 7.2 billion in June 2005, according to

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CTIA, the Wireless Association, the leading industry tradegroup[16].TheconsumerresearchcompanyNielsenMobile, which tracked 50,000 individual customer accounts in thesecond quarter of this year, found that Americans each sentor received 357 text messages a month then, compared with204 phone calls. That was the second consecutive quarter inwhich mobile texting signiﬁcantly surpassed the number of voice calls[17].TheElectronicsIndustriesAlliance(EIA)represents80%of the $550 billion US electronics industry “that providestwomillionjobsforAmericanworkers.”Itsmembersincludecompanies from the consumer electronics and telecommuni-cations industries, among others[17].There is intense industry competition for market share.Telecom taxes form an immense revenue generator for thegovernment sector. Sale of the airwaves (auctions sellingoff wireless bandwidth) is a multi-million dollar industryfor governments, and multi-billion dollar global advertisingbudgets are common. Lobbying dollars from the telecom-related industries are estimated to be $300 million annually.The media is nearly silent on health issues, perhaps in partbecauseofglobaladvertisingrevenuesthatcompromisejour-nalistic independence and discourage balanced coverage of health, equity and economic issues.

2. Evidence supporting a public health risk

Even if there is only a small risk to health from chronicuse of and exposure to wireless technologies, there is thepotential for a profound public health impact. RF radi-ation now saturates the airwaves, resulting in exposureto both users and non-users. The effects are both short-term (sleep disruption, hormone disruption, impairment of cognitive function, concentration, attention, behavior, andwell-being) and they are almost certainly long-term (gen-erational impacts on health secondary to DNA damage,physiological stress, altered immune function, electrosensi-tivity,miscarriagerisks,effectsonspermqualityandmotilityleading to infertiility, increased rates of cancer, and neuro-logical diseases including Alzheimer’s disease and ALS—atleast for ELF exposures). (Chapters 5–12 of the BioInitiativeReport[1]and papers in this Supplement.) There is credible scientiﬁc evidence that RF exposurescause changes in cell membrane function, metabolism andcellularsignalcommunication,aswellasactivationofproto-oncogenes and triggering of the production of stress proteinsat exposure levels below current regulatory limits. There isalsogenerationofreactiveoxygenspecies,whichcauseDNAdamage, chromosomal aberrations and nerve cell death. Anumberofdifferenteffectsonthecentralnervoussystemhavealso been documented, including activation of the endoge-nous opioid systems, changes in brain function includingmemory loss, slowed learning, motor dysfunction and per-formanceimpairmentinchildren,andincreasedfrequencyof headaches, fatigue and sleep disorders. Melatonin secretionis reduced, resulting in altered circadian rhythms and disrup-tionofseveralphysiologicalfunctions.(Chapters5–12oftheBioInitiative Report[1]and papers in this Supplement.) These effects can reasonably be presumed to resultin adverse health effects and disease with chronic anduncontrolled exposures, and children may be particularlyvulnerable[1,19].The young are also largely unable to remove themselves from such environments. Second-handnon-ionizing radiation, like second-hand smoke may be con-sidered of public health concern based on the evidence athand.

2.1. Malignant brain tumors

Atpresent,themostpersuasiveevidenceforcancerresult-ingfromRFexposureisthatthereisasignificantlyincreasedrisk of malignant glioma in individuals that have used amobile phone for 10 or more years, with the risk being ele-vated only on the side of the head on which the phone is usedregularly (ipsilateral use)[1,3,4,6–8,18].While the risk for adults after 10 or more years of use is reported to be morethan doubled, there is some evidence beginning to appearthat indicates that the risk is greater if the individual beginsto use a mobile phone at younger ages. Hardell et al.[18]reported higher odds ratios in the 20–29-year-old group thanother age ranges after more than 5 years of use of either ana-log or cordless phones. Recently in a London symposiumHardell reported that after even just 1 or more years of usethere is a 5.2-fold elevated risk in children who begin use of mobile phones before the age of 20 years, whereas for allages the odds ratio was 1.4. Studies from Israel have foundthat the risk of parotid gland tumors (a salivary gland in thecheek) is increased with heavy cell phone use[7].The risk of acoustic neuroma (a benign but space-occupying tumoron the auditory nerve) is also significantly increased on theipsilateral side of the head after 10 or more years of mobilephone use[1,3].This relationship has also been documented in some of the published reports of the WHO InterphoneStudy, a decade-long 13-country international assessment of cell phone risks and cancer[6,8].Kundi reports that “(E)pidemiological evidence compiledin the last 10 years starts to indicate an increased risk, inparticular for brain tumors (glioma, meningioma, acousticneuroma), from mobile phone use. Considering biases thatmay have been operating in most studies the risk estimatesare rather too low, although recall bias could have increasedrisk estimates. The net result, when considering the differenterrors and their impact is still an elevated risk” [19].The latency for most brain tumors is 20 years or morewhen related to other environmental agents, for example, toX-ray exposure. Yet, for cell phone use the increased risksare occurring much sooner than twenty years, as early as10 years for brain tumors in adults and with even shorterlatencies in children. This suggests that we may currently besignificantly underestimating the impact of current levels of

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use of RF technology, since we do not know how long theaverage latency period really is. If it is 20 years, then therisk rate will likely be much higher than an overall doublingof risk for cell phone users if the peak comes later than 10years. It may also signal very troubling risks for those whostart using cell phones, and perhaps all wireless devices, inearly childhood. We may not have proof of effect for decadesuntil many hundreds of thousands of new cases of malignantgliomas are set in motion by long-term cell phone use.The preliminary evidence that mobile phone use atyoungeragesmayleadtogreaterriskthanforolderpersonsisof particular concern. There is a large body of evidence thatchildhood exposure to environmental agents poses greaterrisk to health than comparable exposure during adulthood[20,21].There is reason to expect that children would bemore susceptible to the effects of EMF exposure since theyaregrowing,theirrateofcellularactivityanddivisionismorerapid, and they may be more at risk for DNA damage andsubsequent cancers. Growth and development of the centralnervous system is still occurring well into the teenage yearsso that neurological changes may be of great importance tonormal development, cognition, learning, and behavior.A greater vulnerability of children to developing braincancer from mobile phone use may be the consequence of a combination of patterns of use, stage of development andphysicalcharacteristicsrelatedtoexposure.Inadditiontothefactthatthebraincontinuestodevelopthroughtheteenyears,many young children and teenagers now spend very largeperiods of time using mobile phones. The brain is the maintarget organ of cell phones and cordless phones, with highestexposure to the same side as the phone is used. Further, dueto anatomical reasons, the brain of a child is more exposed toRFradiationthanthebrainofanadult[22,23].Thisiscaused by the smaller brain size, a thinner pinna of the ear, thinnerskin and thinner skull bone permitting deeper penetrationinto the child’s brain. A recent French study showed thatchildrenabsorbtwicetheRFfromcellphoneuseasdoadults[24].In addition to concerns about cancer, there is evidence forshort-term effects of RF exposure on cognition, memory andlearning,behavior,reactiontime,attentionandconcentration,altered brainwave activity (altered EEG)[95–108],and all of these effects argue for extreme caution with regard to expo-sure of children. The development of children into adults ischaracterized by faster cell division during growth, the longperiod needed to fully develop and mature all organ systems,and the need for properly synchronized neural developmentuntilearlyadulthood.Chronic,cumulativeRFexposuresmayalter the normal growth and development of children andadversely affect their development and capacity for normallearning, nervous system development, behavior and judg-ment[1,97,102].PrenatalexposuretoEMFhasbeenidentiﬁedasapossiblerisk factor for childhood leukemia (1). Maternal use of cellphoneshasbeenreportedtoadverselyaffectfetalbraindevel-opment,resultinginbehavioralproblemsinthosechildrenbythe time they reach school age[25].Their exposure is invol- untary in all cases. Children are largely unable to removethemselves from exposures to harmful substances in theirenvironments.

2.2. Plausible biological mechanisms for a relationshipbetween RF exposure and cancer 2.2.1. DNA damage and oxidative stress

Damage to DNA from ELF and from RF cell phonefrequencies at very low intensities (far below FCC andICNIRP safety limits) has been demonstrated in many stud-ies[1,2,26–35].Bothsingle-anddouble-strandDNAdamage havebeenreportedbyvariousresearchersindifferentlabora-tories. This is damage to the human genome, and can lead tomutationswhichcanbeinherited,orwhichcancausecancer,or both.Non-ionizingradiationisassumedtobeoftoolowenergyto cause direct DNA damage. However both ELF and RFradiation induce reactive oxygen species, free radicals thatreact with cellular molecules including DNA. Free-radicalproduction and/or the failure to repair DNA damage (sec-ondarytodamagetotheenzymesthatrepairdamage)createdbysuchexposurescanleadtomutations.Whetheritisgreaterfree-radical production, reduction in anti-oxidant protectionor reduced repair capacity, the result will be altered DNA,increased risk of cancer, impaired or delayed healing, andpremature aging[36–54].Exposures have also been linked to decreased melatonin production, which is a plausible bio-logical mechanism for decreased cancer surveillance in thebody, and increased cancer risk [34,39,44,46,47,49,50,54].An increased risk of cancers and a decrease in survival hasbeen reported in numerous studies of ELF and RF[55–69].

2.2.2. Stress proteins (heat shock proteins or HSP)

Another well-documented effect of exposure to low-intensity ELF and RF is the creation of stress proteins (heatshock proteins) that signal a cell is being placed under phys-iological stress)[70–80].The HSP response is generally associated with heat shock, exposure to toxic chemicals andheavymetals,andotherenvironmentalinsults.HSPisasignalof cells in distress. Plants, animals and bacteria all producestress proteins to survive environmental stressors like hightemperatures, lack of oxygen, heavy metal poisoning, andoxidative stress.We can now add ELF and RF exposures to this list of environmental stressors that cause a physiological stressresponse. Very low-level ELF and RF exposures can causecells to produce stress proteins, meaning that the cellrecognizes ELF and RF exposures as harmful. This isanother important way in which scientists have documentedthat ELF and RF exposures can be harmful, and it happensat levels far below the existing public safety standards. Anadditional concern is that if the stress goes on too long, theprotective effect is diminished. The reduced response withprolonged exposure means the cell is less protected against